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Exercise on referral 'more effective in older patients'

Older patients who are referred for exercise training by GPs are more likely to be adherent with the programme at 12 weeks, suggest UK researchers.

Their study into one scheme in Northumberland found an increase in activity of 29 minutes per week in those who completed 24 weeks of exercise training.

But only 54% of the 2,300 participants were adherent at 12 weeks and 43% completed the 24-week course.

The age group of 55 to 64 years had the highest percentage completers of all the age groups at 12 weeks (31.3%), followed by 65 to 74 year olds at 30.7%. This compared with those aged 16 to 24 year olds with an adherence rate at 12 weeks of 2.2%.

The researchers concluded that the study showed adherence to exercise referral could be improved by focussing on older patients.

The study - published in BMJ Open this month - goes against a large Health Technology Assessment meta-analysis in 2011 that found ‘considerable uncertainty’ as to the effectiveness of exercise referral schemes for increasing physical activity.

The study followed participants referred from primary and secondary care over a 14 month period. Reasons for referral included CVD (30%), overweight/obesity (42.2%), mental health (13.8%), metabolic/endocrine (6.9%) or other causes (7.1%).

Each participant took part in a 24-week programme including motivational consultations and supervised exercise sessions at nine sites.  The outcome measures of the study were uptake, 12-week adherence and 24-week completion.

Uptake was 81%, 12-week adherence was 53.5% and 24-week completion was 42.9%. Completers attended a mean of 22.87 of a target 48 supervised sessions.

They also found that those with higher BMI (25-35) had higher rates of 24-week completion and older patients and those referred by a cardiac rehabilitation nurse were also positive predictors of 12-week adherence.

The researchers concluded that ‘adherence to and completion of ERS in its present form could be improved by focussing referrals on those age over 55 years’ and that ‘in addition to encouraging participants to attend supervised sessions, there is a need for ERS to promote physical activity outside scheme sessions in order for participants to achieve government physical activity recommendations’.

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